Postnatal Course Registration & Medical Form
It's important for me as your teacher to be aware of any medical issues relevant to the course content so I can either tailor content/movement or be sensitive to the situation. The content of this form is for my purposes only and won't be distributed.

Once you've completed this form please email me to let me know and I'll send you an invoice. Your place will only be confirmed once payment has been received.

Thank you
Rose

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Email *
Phone number *
Name *
Your baby's name *
How many weeks/months old is your baby? *
Which course would you like to book? Each course is 5 classes, 50 minutes each. Classes are limited to 6. *
Where did you hear about the course? *
If you have a known medical condition that means you require any extra assistance/adaptation during the course please give details.
If your baby has a known medical condition that may affect their mobility or means you require any extra assistance/adaptation during the course please give details.
What 3 topics are you MOST looking forward to? *
Required
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